Thirty-three-year-old transgender woman Roxsana Hernández, seeking asylum in the United States, died in ICE custody on May 25, 2018.

She is the sixth migrant to die in the agency’s custody since October 2017.

A native of Honduras, Ms. Hernández was one of roughly sixty transgender women participating in a high-profile caravan of more than one thousand asylum seekers from Central America, organized by Pueblo Sin Fronteras (“People Without Borders”). This was Pueblo’s fifth such caravan of asylum seekers who traveled north through Mexico to the U.S. to escape gang- and drug-related violence in El Salvador and Honduras. About one-third of the asylum seekers in this fifth caravan started entering the United States early in June 2018.

While traveling with the caravan, Ms. Hernández told a reporter from Buzzfeed that, like dozens of other transgender women in the caravan, she had fled Honduras due to the violence and discrimination she experienced as a trans woman. Months earlier, she had been sexually assaulted by MS-13 gang members. “Four of them raped me and as a result I got HIV,” she said. “Trans people in my neighborhood are killed and chopped into pieces, then dumped inside potato bags.”

In that same interview, she also said, “I didn’t want to come to Mexico—I wanted to stay in Honduras, but I couldn’t,” she added. “They kill trans people in Honduras. I’m scared of that.”

Roxsana figured that her only chance for survival was to make the journey to the U.S., even though she had been deported from the U.S. once before. When she arrived at the border with the caravan on May 9, 2018, although she was immediately processed for expedited removal, meaning that she wasn’t allowed to see an immigration judge before being deported, officers from Customs and Border Patrol (CBP) placed her for five days in one of the holding cells commonly known as hieleras (“iceboxes”) for their freezing temperatures.

Ms. Hernández’s health quickly grew worse before she was set to leave the country. “She started coughing a lot, had much pain in her whole body,” another transgender detainee named Stacy (no last name given) told Buzzfeed. “When she ate, she would vomit and had diarrhea from the food.” On May 17, 2018, she was admitted to a New Mexico hospital with symptoms of dehydration, pneumonia, and complications associated with HIV. Reportedly, immigration agents yelled at Roxsana for being sick and denied her requests for a doctor. By the time she was transferred from federal custody to the transgender unit at the Cibola County Correctional Center in New Mexico for detainment (ICE’s only unit for transgender detainees), she was very sick. She was quickly transferred to the intensive care unit at Cibola General Hospital, before being airlifted to the Lovelace Medical Center in Albuquerque. Hernandez was in intensive care there until she died a week later of what seemed to be cardiac arrest. An autopsy analysis is pending.

Despite abundant evidence to the contrary, ICE claimed in a press release following Roxsana’s death that “all ICE detainees receive medical, dental and mental health intake screening within 12 hours of arriving at each detention facility, a full health assessment within 14 days of entering ICE custody or arrival at a facility.” That assertion is belied by a June 20, 2018, report released by Human Rights Watch, the American Civil Liberties Union, Detention Watch Network, and the National Immigrant Justice Center. They contend that more than half the deaths reported by U.S. Immigration and Customs Enforcement (ICE) for a sixteen-month period can be at least partially blamed on inadequate medical care. The report, “Code Red: Fatal Consequences of Dangerously Substandard Medical Care in Immigration Detention,” based on the evidence and analysis of independent medical experts, claims that in eight of the fifteen deaths that ICE recorded from December 2015 through April 2017, “inadequate medical care contributed to the person’s death.” “ICE puts thousands of people’s health and lives at risk by failing to provide adequate medical care to the people it detains for weeks, months, and even years,” said Victoria Lopez, senior staff attorney at the ACLU, in a prepared release. Silky Shah, executive director of Detention Watch Network, said, “The death toll amassed by ICE is unacceptable and has proven that they cannot be trusted to care for immigrants in their custody.”

As if purposely adding insult to injury, the statement issued by ICE regarding Roxsana’s death used her birth name rather than her chosen name (dead-naming), and then proceeded to list her minor criminal offenses, including prostitution, somehow seeking to excuse the death of someone in their custody.

Until 2015, ICE incarcerated trans women in male facilities, where they faced high rates of physical and sexual assault and abuse. Assault by guards is still common. These and other abuses in ICE facilities mirror the dangerous conditions confronted by transgender women in the U.S. criminal justice system as a whole. A National Inmate Survey conducted by the Bureau of Justice Statistics in 2014 found that “33.2 percent of transgender women in state and federal prisons report experiencing sexual abuse by other prisoners, and 15.2 percent reported abuse by facility staff.” The alternative is placing trans women in solitary confinement, risking significant mental health effects, until they can be transferred to a transgender unit, if and when there is space available.

Attorney General Jeff Sessions’ recent announcement that anti-woman and anti-LGBTQ violence will no longer be considered sufficient grounds for asylum has made clear this administration’s open contempt for gender equality and LGBTQ rights.

“The immigration detention system is incapable of handling the acute needs of LGBTQ people, particularly transgender women, fleeing violence and persecution in their home countries,” Luis Scaccabarrozzi, Vice President of the Latino Commission on AIDS, told A&U.

“Roxsana’s death is just one more case that proves inadequate and inhumane treatment of transgender immigrants in CBP and ICE detention,” said Guillermo Chacon, President of the Latino Commission on AIDS and founder of the Hispanic Health Network. Trans rights activist Elizabeth Marie Rivera added, “We need justice in Roxsana’s needless death and action to prevent further harm to other transgender immigrants. U.S. Congress must address the inhumane and deadly conditions for transgender people in CBP custody and ICE detention.”

#JusticeforRoxsana rallies were held on June 6 and continue to be held across the country.

Hank Trout, Editor at Large, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a thirty-eight-year resident of San Francisco, where he lives with his fiancé Rick. Follow him on Twitter @HankTroutWriter.

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Art & Understanding, Inc. is a 501 (c) (3) nonprofit organization. The mission of Art & Understanding, Inc.’s A&U magazine is to collect, archive, publish and distribute the growing body of art, activism, and current events emanating from the AIDS pandemic. It was created for the HIV-affected community.